Rugby to get new guidlines over treatment of concussion

On-field treatment of concussion is to become subject to a new set of “robust”
guidelines to be issued by the International Rugby Board.

At the sharp end: Stephen Jones clashes with James Haskell in this year's Six Nations Photo: REUTERS

By Gavin Mairs

8:50PM GMT 14 Feb 2011

An injury audit conducted jointly by the Rugby Football Union, Premiership Rugby and the Rugby Players’ Association on Monday revealed that concussion was one of the top five injuries sustained last season, with an incidence of 3.9 per 1,000 match hours.

Diagnosing cases of suspected concussion during matches can be a contentious issue, particularly at Test level, as seen last November when England wing Chris Ashton suffered a heavy blow to the head against South Africa at Twickenham but continued playing because he passed the on-field tests, despite calls from referee George Clancy for him to be replaced.

Wales fly-half Stephen Jones took a knock to the head in their Six Nations defeat by England but also remained on the field, despite his level of performance seemingly being impaired by his injury.

Simon Kemp, the RFU’s head of sports medicine who has been part of the IRB working group, believes the new guidelines will make the protocol clear in cases of suspected concussion.

“The IRB are at the final-draft stage on a new set of concussion guidelines that I expect would flag up the importance of players with symptoms of suspected concussion being removed from the field of play,” Kemp said. “Our management of players once they have come off is according to best practice.

"There are particular challenges around assessment in a game in which the potential for concussion is so high and players get dings the whole time. There are some challenges around making decisions in a short period of time on a pitch with a player who is often engaged in the next play. It will be the focus of a very robust initiative. I am very confident the position we will get to is entirely adequate.”

The RFU’s Image of the Game task-force, set up in the wake of the ‘Bloodgate’ saga, proposed the introduction of rolling substitutes to assist medics in diagnosing concussion. The concept of a ‘concussion bin’, allowing medics to assess a head injury in the changing room, has also been put forward.

The weakness of both proposals, however, is that they could be subject to abuse with players feigning injury in order to be substituted.

The audit, which examined data from the England squad and all registered Premiership players and covered training and playing in all major competitions, revealed a 20 per cent reduction in the likelihood of sustaining a match injury last season compared to 2008/09.

There were 636 injuries in Premiership games last season, down from 769 in 2008/09. Last season also witnessed a 43 per cent drop in recurring injuries, the largest fall in the seven years of the audit.

The most common match injury was thigh (4.9 incidents per 1,000 hours), followed by hamstring (4.6), ankle (4), and concussion.